Original Articles
Study the efficacy of rupivacaine versus bupivacaine as a post-operative analgesia in patients undergoing abdominal surgeries by using ultrasound guided Transversus abdominis plane block in a tertiary care hospital | |
Dr. Rakesh Chintalapudi, Dr.Zohra Mehdi, Dr. Dasari Guru Charan, Dr. Mounika Reddi | |
Transversus abdominisPlane block is a regional anaesthetic technique which provides analgesia in abdominal surgeries particularly where the somatic pain forms the main component of pain, from the incision of the anterior abdominal wall.TAP block provides sensory blockade of the skin over the abdominal wall by deposition of local anaesthetic drugs in the neurovascular plane between internal oblique aponeurosis and transverse abdominis muscle. We evaluated the efficacy of bilateral TAP block using Ropivacaine & Bupivacaine for abdominal surgeries done under general anaesthesia in a prospective, randomized, observational, double blinded study. Methodology: The present study is a randomized, double blinded, controlled study which was conducted in department of anesthesiology, NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam during the period of 12 months from 1st January 2022 to 31st January 2023. A total of 90 patients were divided into two groups of 45 each as Group R and Group B. Using ultrasound guided technique TAP block was used among both the groups, in which Patients in the Group R received 15ml of 0.5% ropivacaine where as in the Group B received 15ml of 0.25% bupivacaine on either side. Hemodynamic parameters & VAS score were measured immediate postoperatively and at every 2nd hours till the time for rescue analgesia.Data was spread over MS office excel and analysis was done. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. Data was also represented using appropriate diagrams like bar diagram, pie diagram and box plots. Statistical analysis was made with IBM SPSS 20.0 software and P value of <0.05 was considered significant. Results: Hemodynamic parameters like heart rate, systolic blood pressures & diastolic blood pressures between the Group B and Group R showed statistical significance with p values at 2nd<0.0001,<0.0002&<0.038 and 4th hourly <0.0001,<0.0001 &<0.0001 respectively.VAS score between the two Groups B and Group R at 2nd and 4th hour was also statistically significant with p values <0.00001& 0.00001 respectively. Conclusion: AS score of 4 was attained at 1020 minutes and 660 minutes in Group R and Group B respectively showing that the request time for rescue analgesia was prolonged in the Group R compared to Group B.Ropivacaine with its inherent advantages is more effective when compared with Bupivacaine for providing post-operative analgesia for prolonged time period. |
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